By: Laura Petix, MS OTR/LEPISODE 115


I know what you’re thinking.

And no, I’m not going to tell you that spending more time outside is going to fix all your child’s problems. I am not going to tell you that your child has struggles because they don’t spend enough time outside.

I am not about shaming, and I am not one to promote any kind of one-size-fits-all parenting advice.

Instead, I wanted to amplify the voice of Dr. Laura Park Figueroa, who shares with us some really simple and practical ways we can benefit from what nature has to offer. Yes, even for our neurodivergent kids who hate being outside!

Dr. Laura Park Figueroa, PhD, OTR/L

Dr. Laura Park Figueroa is a pediatric occupational therapist with over 20 years of experience. She is the founder of Outdoor Kids OT, Inc., a nature-based pediatric practice, and Therapy in the Great Outdoors, LLC, an online hub for nature-based pediatric therapists of all kinds. Her PhD research examined the mechanisms of change at work in nature-based pediatric occupational therapy.

You can connect with her on Instagram @lauraparkfig and follow Outdoor Kids OT @outdoorkidsot.

What you’ll hear in this episode:

Is nature-based school better for everyone?

You would think so, based on how some of parenting experts and schools market it.

Certainly nature-based preschools can be incredibly beneficial to many kids, even some of our neurodivergent kids! But the idea that nature is a panacea, a cure-all that will fix your child is pervasive and woefully incomplete.

Laura Park Figueroa mentions that many of these nature-based programs can be incredibly difficult for sensory sensitive kids in particular. The large-group setting with not much ability to provide accommodations and specialized instruction for our neurodivergent kids can set our kids up to fail.

You really need teachers and providers who know how to scale back, adapt, scaffold a task and help co-regulate a child.

This is why Laura started her nature-based OT with smaller groups, where kids learn from one another and an OT who can provide guidance and support as needed.

What does a nature-based OT session look like?

A nature-based occupational therapist is still an occupational therapist, Laura reminds us. So they would be using the same theoretical foundation as a therapist who works indoors. The difference is that they are taking our kids outdoors to brave the real-life challenges that we can’t control, with limited supplies, with unpredictability. The goal is to teach our kids how to adapt to a real-life challenge.

I call nature the blameless co-therapist. Kids can’t blame nature for the tree falling down. But it forces them in that moment with the therapist to collaboratively problem-solve and figure out what they’re going to do. There are these opportunities to adapt in the face of these real-life challenges that we don’t have in an indoor setting.

Dr. Laura Park Figueroa

Is there research behind how being outdoors affects our kids?

Although there isn’t much documented evidence about the benefits of nature-based OT in particular (it’s such a new movement), there is, however, a lot of evidence to support being outdoors.

A few points that Laura thinks parents will find interesting:

But remember: We don’t want to simply throw our kids outside and expect them to reap all these wonderful benefits. It takes some thoughtfulness and detective work to figure out just how our kids might engage in nature in a way that is suitable for them.

How can we make the outdoors more comfortable for our sensory avoiders?

I won’t hesitate to tell you that I myself am 100% an “indoor cat.” And the simple act of being outside does not inherently bring me joy. So I asked Laura how we can help people like myself and kids who are sensory sensitive get started with being more comfortable outdoors. Here are her thoughts:

What are some simple tips to engage with nature?

We’ve covered the benefits of outdoor play, and we’ve covered how to consider our child’s sensory profile when providing accommodations. So what can we actually do? Here are some practical tips:

Many of these activities can be done outdoors or indoors with the right set-up!

How do I find a nature-based OT near me?

Laura tells us that a simple Internet search for “nature-based occupational therapy near me” or “outdoor occupational therapy” should yield some helpful results.

Laura also recommends asking around in your community.

The ConTiGO Certified database is still in its early stages, but some may be able to find an option here.

There are so many benefits to incorporating nature into our child’s play, and there are so many ways to do it! I hope you’ll find something that works for your family, even if it looks very different from what most other kids seem to be doing.

Episode Links

Helping Kids Thrive Outdoors with Nature-Based OT
Speaker 1 0:00 There is a lot of research on these types of outcomes with kids like nature play or outdoor play or exposure to nature, helping kids build resilience, helping them to be more cognitively flexible. They've done studies where they give kids chest outdoors and indoors for like working memory, and their working...

Speaker 1 0:00 There is a lot of research on these types of outcomes with kids like nature play or outdoor play or exposure to nature, helping kids build resilience, helping them to be more cognitively flexible. They’ve done studies where they give kids chest outdoors and indoors for like working memory, and their working memory is better outdoors. Laura Petix 0:25 Welcome to the sensory wise solutions podcast for parents, where parents can get real actionable strategies to support kids with sensory processing disorder. I’m Laura, OT and mom to Lilyana a sensory sensitive kid who inherited my anxiety and my love for all things Disney. Consider me your new ot mom, bestie. I know my stuff. But I also know what it’s really like in the trenches of parenting a child with sensory processing disorder. Speaker 2 0:54 Okay, Mom enough about me. Let’s try the podcast. Laura Petix 0:59 Hey, everyone, welcome back to the podcast. Today I am interviewing Dr. Laura Park, Figaro Ella. She is a pediatric occupational therapist with over 20 years of experience. She’s the founder of outdoor kids ot Incorporated, which is a nature based pediatric practice. And she’s also the founder of therapy in the great outdoors, LLC, which is an online hub for nature based pediatric therapists of all kinds. Her PhD research examines the mechanisms of change at work in nature based pediatric occupational therapy, you can connect with her on Instagram at Laura Park fig, and follow outdoor kids ot at outdoor kids ot on Instagram. In this episode, you’re going to hear me talk to Laura about all of the great benefits that nature has on the nervous system, particularly in kids, she’s going to give us a little bit more insight into the research pool that is looking at the effects of nature on kids. And you’re going to hear me talk freely about how much I am not an outdoor person, which is I feel like an anomaly in the OT world. I think it’s it’s one of the things about me that I feel bad about because I’m an OT. And if you’re an OT, you know the importance of nature, which logically I do, but my nervous system doesn’t jump to nature as like a form of comfort. So you’re gonna hear that conversation. And I just hope that at the end of the episode, you feel maybe encouraged that you are already on the right track, maybe your family spends a lot of time outdoors. Or maybe you get the motivation to try something new. Try to incorporate a little bit more nature play inside your home or in your backyard. Or maybe bring your child out to more nature friendly areas. Alright, let’s get into it. Well, hello there named twin, Laura, it’s so good to have you here on the show. Unknown Speaker 3:03 Thank you. I’m so excited to be here. Laura Petix 3:07 We get to talk about something that I often preach to families, but don’t always practice this as much. I always talk about myself as an indoor cat. I just I really, I like my indoors. I like controlled temperature, and all of that. But outside at nature, I always say is like the ultimate sensory experience. Yeah. And so you have a lot of experience and research knowledge on this topic. So I can’t wait to learn more from you today. Yeah, Speaker 1 3:46 and I think I know, we said this right. Before we record, we we just hit record, we were laughing about it, I think it’s going to be a really great conversation because of that. Because there have to be parents out there who relate to your side too of like, actually nature is kind of dis regulating, you know, to me, right? Totally. So totally. So some people, there’s a lot of research out there about the benefits of nature, and we’ll get into that for kids and for parents. But I think the what makes for really great conversations is when we have like diversity of opinions. I know your podcast is all about neurodiversity. So I think it’s just going to be a great conversation so big. Laura Petix 4:25 Exactly. There’s got to be other parents out there who feel like me and kids who feel like me. And so how do parents motivate them to start getting into this? So before we get into all of those details, let’s rewind a bit and I would love to know how I guess nature based ot even came to be on its own as like a setting. I love the diversity of OT like the settings like you there’s like no limits to what OTS can do. But I would love to learn about the history of that and then also how you got into this field. Speaker 1 4:58 Yes Oh, gosh, it’s like how far back do we want to go? I mean, there’s an article I know of that was kind of talking about how nature was used, you know, with people who had tuberculosis way back in the day, right. And this, this whole movement that we’re seeing now, specifically of OTS moving into nature based practice is really tied to like, the original roots of our profession, being in like, mental health and wellness or very holistic, right. So there’s all these things way, way back in the past. But most recently, Richard Lewis wrote a book called Last Child in the Woods. And this is kind of the book that is, most people in the nature based therapy movement kind of heralded as this like kicking off the movement of children in nature. There’s a huge nonprofit children and Nature Network that people can follow that he started. But basically, he was writing about how modern day life has just disconnected all of us adults and children, especially from nature and the outdoors. And so that kind of kicked it off. And I read that book when I was in my master’s program, I went back to school for 15 years as an OT and did my master’s degree because when I graduated 20 something years ago, you did not need a master’s to practice. I am dating myself here that I had a bachelor’s with practicing for 15 years but so anyway, I read that and then I also was I also read Angela Hanscom book balanced and barefoot which I recommend for all families to read. It’s a much more accessible book maybe than Last Child in the Woods is it’s it’s really written for parents talking about just the sensory and developmental benefits of getting your kids outdoors. And so I actually did the training for timber Noack. And I ran really large group timbernook is not therapy. It’s an outdoor camp program, really amazing curriculum, gets kids in touch with nature. And as I ran my my first programs through that, and I kind of started my nature based practice at the same time, but I was doing these big, these big camps. There were kids that I was seeing for therapy in the clinic that came to these camps, and had a really hard time participating in a group of 20 kids with maybe five or six therapy, we had a therapy me leading right the town, right. But we had ot students and other camp counselor staff that were there. And I think I think I really want parents to know that nature is not a panacea, it’s not something that’s going to fix your child. Right. And maybe at the time, I had kind of thought, you know, that, that these kids that I was seeing in the clinic, they just needed more outdoor time, they just needed to come to timber dock and have this, you know, amazing sensory experience for a week. But there were there were kids I had there were some kids who loved it, right. But there were there were a few kids enough that that gave me pause to be like, our larger group programming outdoors is not really meeting the needs of kids who are really sensory sensitive, right? Yeah, I think it’s really good for the kids who are like, they, they need all the input, right. But the kids who are sensory sensitive, like kind of how you’re talking about you are like you want to be indoors in the Kodaly environment, it’s really hard for them. And that just got my wheels turning like I, I felt like what I really wanted to do was spend my time in smaller groups of kids, like really supporting the kids who needed, needed the support, but I also knew could really benefit from that sensory experience of being outdoors. So, around when I was doing those larger group camps, I decided to start my nature based occupational therapy practice. But the key thing in that was that I was going to do outdoor services, but also do them in small groups. So like three to five kids. Yeah, because I really believe in the power of play like, yeah, and it’s, it’s kind of a contrived thing when an adult is playing with a kid, even if you’re an amazing therapist, or an amazing parent, right? Kids kids engage in play more freely when they have other other peers nearby and they can kind of you know, they they learn from one another, they they play off of one another and their their strengths and challenges kind of either come come to be conflict which we can work through, right? Or they really learn from one another’s strengths, too. So yeah, that’s kind of the background. So that was 2015 that I started my nature based therapy practice. So it’s been nine years now. And it’s just grown and grown. I have two locations. Now I my original practices in California. I moved to Wisconsin three years ago to I’m live near my husband’s parents because they’re in their 90s. And so I started a branch, little pun intended there of the practice, here in Madison, Wisconsin, where I live now. So I’ve just seen it, I’ve just seen it really, really benefit the kids we serve. But that’s kind of the the background of how I started, and I train other therapists to do this work. Because it’s become such a, such a movement. Now in OT, and in other professions, there’s speech therapists doing it, there’s physical therapists doing it, mental health counselors have kind of been leading the way to in this work. And so it’s really a movement of getting kids outdoors. And what I’m most concerned and most passionate about is getting kids who are neurodiverse, or have any kind of special learning need outdoors, because I feel like those large group programs often don’t cater to their needs. Yeah, or can’t. So yeah. Laura Petix 10:54 So parents who are listening to this, it’s who have kids in OT probably have more of experience with clinic based OT or school based OT. And some of the main sort of presenting concerns that usually lead them to OT are things like fine motor challenge is focusing in school, potty training, GI issues, sleep issues. And so they work with an OT. And there’s a little bit of a mix of a top down approach that OTS will use, and like task training, and like actual handwriting, and then they’ll also do like bottom up approaches to strengthen fine motor and all of the underlying skills. Yeah, I had client factors. And so within an clinic setting, you know, we have games and obstacle courses and things like that. So can you help parents understand how nature based ot what like a session would look like and how that can still translate to some of these presenting kind of concerns and behaviors that they would otherwise go to like a traditional clinic setting for? Speaker 1 12:02 Yeah, so I would say I’m really, when I talk to therapists, I’m really big about saying, You are not a nature based therapist, you are an occupational therapist, working outdoors in nature, in the setting of nature, or your physical therapist working outdoors and studying nature. You are your licensed profession first. And so a lot of the things that we are going to be doing in an outdoor session are the same, they come from the same theoretical foundation, essentially, or the same intention that a therapist working indoors would be, would be using, right? I think that the difference is that I mean, my own research for my for my PhD, I went back and I didn’t say that part. But I went back and did my PhD. And I studied nature based ot so in my research with OTS who work outdoors in nature, what what they are saying is that this idea of braving those real life challenges, like the things that come up outdoors in nature that we can’t control, right, it’s not a climate controlled environment, we don’t have all of our, you know, supplies in the cabinet, and we can just oh, if this game isn’t going so well, we can we can kind of wrap that up and decide to do something else right in the moment, right. So you have limited supplies, usually when you’re outdoors. But in some ways, that is what, at least OTs, that I that I worked with, in my research. That is that is the beauty of nature based therapy is that the child actually learns how to adapt in what what I termed, in my research, a real life challenge. It’s not something that is made up by us, it’s not something that we can predict. It’s you go out in nature, and you were gonna go to the pond, but this tree fell down and it’s blocking the whole path, but like a literal, giant, huge tree that you cannot go past. Well, what are you going to do in that moment? You know, and so it’s, there’s, there’s these opportunities to adapt in the face of these real life challenges that we don’t have in an indoor setting. That actually, OTs own that as like the benefit of the therapy session outdoors. So yes, we’re going to do a lot of the same things that we do in an indoor setting, right? But we’re going to be using nature elements instead. So maybe if we’re working on writing, we’re going to be drawing in the sand or using sticks to form the letters or thing that things like that, you know, or if we are doing swing activities, we may be doing that outside but we might be using pine cones instead of instead of cones or whatever you may use in a clinic or like rings to toss at something. And there’s also there’s also therapists it’s going to depend on the therapist like I feel like some therapists are much more go into nature and it’d be very like low supplies like not look like a clinic at all. And other therapists use a lot of clinic looking stuff, you know, they might use the plastic rings with cones to throw from the swing, or whatever that you would use in a clinic. So it’s gonna look different depending on the therapist, but it’s really that environment of nature that adds that added the multi sensory elements to the session, and those unexpected real life challenges that that make us have to adapt in the moment to something that is not contrived by the therapist, right? It’s not something I called nature. The blameless co therapist, like nature is a therapist in the session, right? But they’re kind of blameless, like nature doesn’t get kids don’t get mad if a tree falls down. They can’t blame nature for the tree falling down. But it forces them in that moment with the therapist to collaboratively problem solve and figure out what they’re going to do. Because oh my gosh, look what look what happened, like, this tree is blocking our way. What should we do right now? You know, so those moments come up a lot outdoors in nature. And it’s just like one of the big things I think that that is different with how we would be working in a clinic. Laura Petix 16:16 So what what does the research say about nature based ot maybe in comparison to clinic based ot if there’s specific for like, you know, maybe it’s best for these kinds of kids who work on your on just straight, like sensory modulation stuff? Or it you know, clinic based better for fine motor? Like, is there specific research targeting different skills? Or what’s kind of the latest that you can summarize for us? Speaker 1 16:44 Well, the the funny thing is that there’s very little research on because this is such a new, a new yet tethered to foundational things in our profession kind of movement. Yeah, there’s not really research out there on it. In fact, that is something that I actually said at the end of my article that I’m about to publish on my dissertation, which is, we need research, comparing outdoor therapy to indoor clinic based or indoor school based therapy we need that kind of research is just not out there yet. Because it’s such a new kind of thing. And in our field, in particular for OT, but from my dissertation, there is so much evidence to support being outdoors for ot sessions. So I’ll go over like a few things that parents will find, I think, very interesting. So there is research about physical activity that when children when you green, a playground, basically you put natural elements onto a playground versus like if it’s a built playground structure, like the monkey bars, right? Sure. That that increases physical activity and children that they move more, you know, they’re more kind of internally driven savemore they’ve done studies with like, you know, Tracker, like pedometers on kids basically to see. Okay, it’s kind of cool. There’s like two studies, I think that have looked at that. So so there’s that and then there is when we think about our immune system function. There’s such interesting research, they did a study. This is someone I think she’s in Japan or her last name Saab Coase, sob kayo. She did research on children, she found that children who played outdoors more had more fecal serotonin. So serotonin is that happy neurotransmitter? Right? That’s how like, antidepressants work by increasing serotonin in the body. Essentially. They had more fecal serotonin in their in their poop like she studied. You know, Laura Petix 18:50 I didn’t even know serotonin can be found in poop. I didn’t either. Like I literally thought that was just a brain chemical. Yeah. Okay. So Unknown Speaker 18:58 what it’s showing is that there’s, Laura Petix 19:01 there’s positive of happier poop. Speaker 1 19:05 And hopefully, happier mood too. But, but, but what she was looking at was, you know, children, we our immune systems need to be exposed to like both both positive and kind of, for lack of a better word, like, harmful micro microbiota, and the environment. And so when we, when we have in our microbiome, like in our gut, right of our body, when we have a mix of all of these different things that we get from putting our hands in dirt, essentially, that can like help, that can like help the gut function in the body, the gut microbiome, and then there is this increase in serotonin in the fecal matter. So that’s like, that’s like, our data kind of research, right? There’s not a lot of that in the nature based world you know, it’s kind of like Oh, we did A study and we found out that mood was improved after you right? But, but that was just such an interesting study because it it kind of shows it improves immune system function in children. And it was specifically done with preschoolers. And I know a lot of your listeners are preschool parents. Yeah. So this is not looking at adults, it’s looking at preschool kids who play outdoors, right? So there’s that. And then the other thing I think, too, is like vitamin D from sunlight is so important in regulating sleep wake cycles for our kids. And if kids aren’t, if kids aren’t getting, especially morning sunlight, that’s like a really simple thing parents can do is to try to just get outside for a little bit in the morning to get some sunlight in your kid’s eyes. Like it’s really Yeah. And if you can’t just sit by a window to get some sunlight. I mean, it’s, it’s important for our sleep wake cycles. And then when we think about, so that’s kind of physical health stuff. When we think about mental health, I think all of us can kind of know, like, where do we go for vacation? Right? We go to beautiful places, usually somewhere on the ocean. And even if you are gonna stay inside, you know, you’re sitting and you’re looking at the ocean. We all know, as adults, like nature has a calming effect on our nervous system. In those ways, like those are the places that that calm our minds and help us kind of stop ruminating on things, you know, we stop, stop just getting so overwhelmed in our thoughts that can help us just kind of calm our bodies down. But there is there is a lot of research on these types of outcomes with kids like, yeah, nature play, or outdoor play, or exposure to nature, helping kids build resilience, helping them to be more cognitively flexible. They’ve done studies where they give kids test outdoors and indoors for like working memory. And their working memory is better outdoors. So there’s, there’s a, there’s a lot of stuff out there that we can look at. And then there’s there’s a big one too, because I know like ADHD is one of the most commonly diagnosed neuro neurodivergent kind of diagnoses, right that we have in the US at least today. I don’t know about other countries. And there’s a lot of research about green spaces and outdoor spaces helping to to kind of minimize the the challenges with attention that kids with ADHD have and specifically done with with kids who have ADHD, like not looking at like general population and saying that right, right. It’s going to help improve kids with ADHD because we looked at regular kids. No, it’s actually studying kids with ADHD. So yeah, I mean, there’s I could I could just go on and on. There’s, there’s so much research out there. Laura Petix 23:01 What I think about is when I have a specific listening protocol, like a therapeutic kind of music protocol, right? A lot of them have something that’s like a nature based track and Nature Sounds interesting. We all know, whenever, you know, whenever I think of like a calming spa music, there’s always sound like running water. There’s birds chirping, it’s always like nature, like synthesized sounds. Is there research about like the auditory aspect of nature? On our nervous system? Like specifically? I don’t know if there’s anything on kids or just like, what is it about those sounds that are just always in like these, like calming kinds of tracks and things? Speaker 1 23:48 Yeah, I you know, it’s that’s such a great question. And I don’t know of any research off the top of my head, but I might be going down a Google Scholar, rabbit hole after this. Because it’s an interesting, it’s an interesting thing to think about. Right? And I’m sure I’m 100% positive that there’s something out there on that topic. Yeah, there’s something like it’s Laura Petix 24:10 it makes sense when you hear running water like trickling water or like birch. Like it is just naturally calming. But is that like, you know, a primal like, instinct like justice? You know? Yeah, yeah. I mean, I like calling us back to nature. Like, Speaker 1 24:24 right when you think about that, I mean, this gets that’s this gets kind of meta, right? But when you think about like, our ancestral history, like, we actually lived, in very close connection with nature for more of our existence than we’ve lived disconnected from it. Yeah. And so that those sounds to me are when you think of running water, like water is essential for life. And so for humans, it makes sense to me that there’s something primal about the call. Only nature of hearing water that we would naturally calm down because it signals to some kind of very primal part of our brain. Yeah, that we are safe because there’s water nearby to sustain our, you know, yeah. And we forget that so easily. That’s part of what my my model that I developed, I developed a theory, we don’t need to get into it here. But I developed a theoretical model to kind of explain how nature based occupational therapy brings about change and children like what are the elements that actually are, are bringing about good outcomes from therapy. And so one of the things is that the model that I mentioned in my in my kind of summary is that the model actually brings attention to our awareness that we are dependent on the earth, and the earth is dependent, maybe not so much on us, probably are more dependent on the earth and interact yet but, but that our actions, you know, it’s so intertwined and, and we’re interdependent with the earth and not independent of it. And I think when we go back to those ideas, it can really help us think about, like, how can we reconnect our kids to nature to give them some of that sense of safety that we eat as humans, right, that’s so primal to our just existing in the world and like, going about our day and, and regulating ourselves? So, yeah, Laura Petix 26:28 so let’s talk about that, then. I’m sure. Like we talked about earlier, we kind of alluded to people who have more of the traditional, like, sensory seeker kid, like, I can think of a few of that, like, they’re already doing some pretty fun, risky play, very resourceful play out in any kind of nature, like they will be out there. So parents don’t have to do much for them other than make sure that they don’t get a concussion or break an arm or a leg, right. So let’s, let’s focus more on giving tips. And you know, we’re all about the just right challenge here. For people like me, for people who have kids who have the same profile as me where I think of outside and even my daughter, I think of outside, you know, hot sweaty, you have to put sunscreen on like wear certain clothes that are uncomfortable the sound of bees buzzing by, like the bark, like, like those things that that even though maybe primal, those like the sounds and some elements of it can be calming, but might make my nervous system feel triggered or unsafe in order to access those parts, like how do we get parents to like what’s like the just right challenge for their kids to start it so that they’re not just like dysregulated? Even more from being out there? Speaker 1 27:41 Yeah, yeah, I think, well, the first thing I’d start with is make sure that you’re doing something that the child wants to be doing. And it does, it does start with us, in some sense of us being enthusiastic and excited about whatever we’re going to do. Right? And then it would be very much on a case by case basis of like, what are the things that might be triggering the child? And how can we mitigate those? Or how can we make some sort of accommodation for those things in order to make the experience more enjoyable? We have seen in our sessions, like just I think, I think it’s very powerful when you get a mix of kids together who all have different sensory needs. And they they see from one another that it’s not they they learn from one another’s watching one another, right? And so when when we have a kid in a group, who is a sensory enthusiast, and we’ll dive right into the pond, right, but they’re friends with the kid who’s sensory sensitive like that, that is so powerful, more powerful than me as a as a therapist saying, Okay, let’s, let’s go in, let’s just, let’s just see if we can throw rock in the pond, you know, first Yeah, kind of sure, you know, slowly, slowly waiting them in. But I actually think that the most, the most exciting and special moments for me when I’ve been leading outdoor groups has been when the really sensory sensitive kid does something, like get their foot wet, and they laugh about it instead of cry, you know, and it’s like, it’s like, it’ll make me cry. And then I cry because I’m like, we get crushed. Like, it’s so those moments of telling parents, you know, of just saying like, Oh my gosh, like, remember the first week when he was here, and he would not touch the dirt? Like it was like, yeah, oh, yeah. You know, and then now like, he’s today, look at his head. Look at the picture. I’m gonna send you later, you know, and his hands are covered like so. It’s just a matter of really for each kid, you know, figuring out what do they need to be able to participate? Essentially, that’s what we’re all about as OTS is participation, like, just if participating means you’re touching a finger to the activity we’re doing and if that’s what you’re gonna do, or maybe it means later on that your hands are all in the mud, you know? That’s, I think answer because it’s for it’s so dependent for each kid, right. Laura Petix 30:26 And I think though, that that’s what, what differentiates this from like, those outdoor like preschool programs that have or like those, those other nature based camps, that parents are like, Oh, I nature, great for my neurodivergent kid, but like, as you kind of mentioned in those larger groups, or with the less trained eye for people who are not OTS who are leading them will not know how to, like scale back, adapt, scaffold the task and to like, co regulate the child as much in a larger group and also without that education. So I think that’s, that was one of my questions was, you know, if parents hear this, you know, is it enough for them to just like, you know, there’s outdoor for school, there’s like, all of these nature based preschool programs. That, you know, I wouldn’t say don’t do but there, it’s not the same as a therapeutic based? Speaker 1 31:21 Oh, 100. Program? 100%. I mean, that is I do, I do think that that’s really important. And I have I do a lot of education on that actually, like on my Instagram account and stuff to say, like, nature based therapy is different than an enrichment program or an educational program, because we are working on goals, there are specific goals. And oh, this is something I wanted to say too, is that nature based therapy, as much as it pains me to say it, I want it to be for all children, it’s not necessarily right for every single kid. And that’s so hard for me to say, because I want to be like, we can just serve everyone, you know, as therapists, we want to be so inclusive of everyone in what we’re doing. But there is a, when you’re thinking about nature based therapy for a child, there is a there is a clinical reasoning process that we go through to decide whether or not nature based settings are the best setting to see the child for their specific goals. So that’s really important. Can Laura Petix 32:25 you share more about that, like an example of like, what would have like a case study or one child recently that you’ve had to say, like not the best to support that goal for this child? I’m thinking like more physical barriers, like if someone has mobility aids or things like that, but there might be other things that I missing? Speaker 1 32:44 Yeah, so it kind of depends on the setup of the therapy service, right. So there are there are nature based practices that work with children who have multiple physical needs, where they’re in wheelchairs, maybe even motorized wheelchairs. My practice mostly serves kids with sensory integration, and autism and ADHD, that’s pretty much the the diagnose diagnoses that we see. So it would kind of depend on the child and the environment that the therapist has available to them at their nature based setting. But I think the the example that comes to mind most quickly, because it’s what we’ve dealt with in my practice is children who are in one of our nature based therapy groups. And the group is too dysregulated for them. So this has a little bit to do with nature. But also with the group setting. It’s a good example of how the other pairs Yeah, right, of not all settings are right for all kids. And so a lot of times, with with a child like that this has happened. I’ve been in practice, I guess this is my ninth year with my nature bass business. We’ve had like a handful of kids over the years that this is this has happened for because our intake process is pretty good at you know, figuring out who needs what. But you know, you just can’t know until you get in a group with four or five other kids and you’re out there in a nature setting. And sometimes it’s not the right fit. And so we would move to like an individual where we can kind of cater to that child’s needs more right than we can in a group with five kids. Laura Petix 34:24 So you’re saying you might recommend one on one nature, but is is there like something that would make the child not like a good fit for nature based therapy period? Not just like a one on one nature? Speaker 1 34:38 Yeah, I mean, we haven’t had that in my practice, but that’s hard for me to know. And I haven’t heard of other I mean, I work with a lot of nature based therapist. I haven’t heard of other of other practices. Ever. I’ve never heard it come up in any conversation I’ve had with any nature based OT. This child was just not right for nature based outdoors. Right now, if you use a kind of research brain to think about that it could be that like, the people who seek out nature based therapy are self select right? So we’re not, you know, I don’t mean it like it could never be the case. Sure. I do think that it is a, it is such a wonderful place for regulation of our nervous systems. Like, even when I think of the worst days that I have had out in nature, where it is really cold, and rainy. And maybe we had some kids that had conflict or in the group and I had to kind of help modulate them, you know, and I help them manage their conflict resolution and all of that, which sometimes doesn’t really happen until the next group, but you know, because when we’re in fight or flight, we can’t really rationally think so. But even even when there have been those really hard days, there’s something still refreshing in some way or not as taxing in some way about, yeah, the fact that the session was outdoors, we were moving our bodies, we got fresh air. And yeah, yeah, I don’t know. So I haven’t I haven’t had that be the case. I don’t know that that would be for every single person. You know, I don’t know everyone in the world that does nature based therapy. But we haven’t had anyone that, like we thought we’re like, even with an individual service. Because with individual we can really, really Oh, yeah. Adjust. I Laura Petix 36:27 imagine. I imagine that in a group setting the what you made me think about like the fight or flight is I imagine, there always has to be more than one therapist. If a child like I’m imagining if a child did had fight or flight and they like ran off, and you’re like literally in the woods, like you can’t, what do you do between? So is that kind of like how do you ensure safety? In a group setting with no physical construction of where a child can run and hide to? Speaker 1 36:54 Yeah, yeah. So that’s a really good example, actually, now that you brought it up of a kid who might not be appropriate for an outdoor, like, if a child isn’t a Loper, and they Yeah, they need the environment to feel safe, right like that. And we could take little steps. And I also, I guess, I kind of also want to want to remind people that nature based therapy can be done in an indoor set, you can bring natural elements into into an indoor setting and have that element of nature in there. I think the less plastic the better. I mean, plastic is, yeah, all over our world, Laura Petix 37:31 or like in a backyard fenced in area door with grass, like it’s still outside, but like, fenced and because, yeah, and so that makes, that makes me think you know, so places like New York City, Los Angeles, I live in Orange County, it’s very metropolitan, there’s dedicated parks, but there’s not this like wilderness like freely Wisconsin, kind of like hikes that we have, right? So obviously nature is nature, but it’s going to look a little bit less nature with more concrete and more flat things available. So how does that look? Like? What kinds of things can parents do in a place that has less accessibility to that like, open ended nature? Element? Yeah, Speaker 1 38:16 yeah. So I would say loot so loose parts play is a big have. Have you talked about loose parts play on the podcast? Or Laura Petix 38:26 I haven’t talked about it much, but I know what you’re referring to. Yeah, yeah. So Speaker 1 38:31 loose parts play basically refers to the idea that that children will play very creatively when they have access to a bunch of items that don’t really have a set purpose. Right. So one thing that you can do in a very small area, like it doesn’t have to be you could do this on a back patio even. Yeah, is. I often laugh because before I throw any kind of recycling away, I’m like, wait, could I use this in a nature based session? Should I recycle this? You know, think about that. But when you’re when you’re putting your recycling away, like things simple things like egg cartons, yogurt, containers, plastic spoons, from your takeout, whatever like, like reuse the plastic for lay purpose, you know, make it worth something using the plastic and have those things available to kids with some natural elements. So if you live in a really urban area, and you just have a patio, right, maybe you don’t have a large outdoor space, you could have a little pot of dirt, you could have a small tub of water, like let them get messy and dirty, even if it’s in a small space, right? Give them that opportunity. And for a kid who’s sensory sensitive because I know we’ve kind of focused our conversation on that on on for good reason. Because those are the kids who have trouble maybe you know, just giving them opportunity that that that really to me is the thing is like, is the encouragement and the support and the safety of like a young person with them, supporting them doing that, and giving them the opportunity to do loose parts play with some nature elements, I think is a great like, first step towards getting out. I Laura Petix 40:17 love that, you know, that is a really good idea because a lot of parents do like I was like this to at the very beginning, I was like, well, she hates it. So like, I’m not going to take her outside. Like, why would I do that? But yeah, obviously you. It’s that very mix of like, yes, I want my child to be safe and accommodated and regulated. And yet, who knows if today, she’s going to want to touch the pine cone, even though like yesterday, she didn’t. So like you’re never going to know unless you offer it but not force and not like you know, try to quote desensitize or get them to get used to this. It’s just, you’ll never know unless you like continue offering. So I like that idea. And yeah, so when when we were in the pandemic, and I tried to go outside I would I brought a plastic bin outside but then we collected little nature things that I would pick up for her she did not want to touch twigs like grass. And then when we brought that little plastic went back home and she added water and she mixed it with like a spoon. Like that was how much nature she could handle. Yep, that time. So, but they gotta make it happen. Yeah. Speaker 1 41:20 Yeah. And that’s so great. Because that’s like making it playful. Right? Like kid like, right? With those loose parts you can set up like a potion station where they can make potions, you know? Or like, there’s so much you can do with those with those natural elements. But but make it play for the kids allow them the freedom. That’s the big thing that I really want parents to hear is that it? It doesn’t have to be complicated. It doesn’t even have to be complicated as the loose parts. It could be walking around the block after dinner. Yeah, yes. Right. Notice nature like, like, Yeah, show your own. So Rachel Carson was this environmentalist in the mid I think she was in like the 50s and 60s, and maybe aging her wrong, but but she was really she was really big about modeling a sense of wonder for children. So like, having as as an adult, like, if you want your child to love nature, and I do think that should be something that all parents would would be it would be good for us to instill in our children is a love of nature, a love and respect for nature. And that starts with like a connection to nature like noticing nature, loving nature and having this like sense of wonder at what is out there. And that could be as simple as, I’m not kidding, this is how I did this, because I do not live in an outdoorsy family. Like pretty much no one in my family, but me likes the outdoors. So I like I like plan all the trips, and like everybody likes it once we’re there. But like, It’s me doing this right? Or in the past when my kids were younger. But literally, it can be as simple as you’re driving on the highway and you see a hawk and you’re like, oh my gosh, did Laura Petix 43:09 you see that? That was a hawk, you Speaker 1 43:12 know, like just just having a sense of wonder about things you notice. So noticing nature. I mean, that is like the simplest thing we all can do as parents you don’t even have to like nature, just when you’re on your way in from the car to the house, when you’re when you just got groceries or really noticing the cardinal that’s on the tree or whatever it may be whatever bird is in your area, that’s really cool to see. You know, I Laura Petix 43:36 love the idea that like outdoor nature like scavenger hunts, right, so like finding things purple, or orange green or, you know, an even for our kids who are, you know, I am one, I will never put a thumbs down to screens, parents need to use screens. There are some kids who really, really love screens. But like if you want to merge the two, let them bring a bone out and take pictures of the scavenger hunt thing and then go back home and draw the picture or look up the plant that there’s apps now where if you take a picture of a plant, it tells you like what the plant is like, Yeah, you can’t merge the things that doesn’t have to be like forcing them to go like sit on the front stoop of your front door and take a magnifying glass and like look at a blade of grass like and then go to rake the grass and like there’s lots of different ways it doesn’t have to be which is what I learned. It doesn’t have to be like frolicking in the woods with shoes on which is like, what I think of as like danger like, oh, that sounds like way too much like no, I just like want to be indoors right? It’s painful Speaker 1 44:39 to my system to even think about that. Laura Petix 44:44 So practical question and I guess like insurance probably is no more it does not. So have our nature based ot Speaker 1 44:53 well. So this is interesting. There are nature based practices that take insurance because why Oh, again, you are an OT? Or PT, yeah, whatever therapist is working outdoors in nature, as long as you are billing appropriately and ethically right for the services that you’re providing and the goals you’re working on, then then yes, insurance should cover it the same way that they would cover any kind of OT provided in a clinic now, are there weird things where sometimes they won’t cover community based services? Yes, because our insurance system is really broken and crazy in America. But but there are nature based practices who take I’ve worked with practitioners in Maine and Alaska of all places, there are multiple nature based OTAs in Alaska who take Medicaid and Medicaid. Yeah. So again, it’s like the setting of the therapy. If you, if you think about it, it’s like, well, Medicaid is not going to say that this clinic doesn’t get paid, because they’re at a different clinic location than this other clinic. Right? It’s the same thing. So it’s like, it’s just a setting that we’re working in, but we’re providing if we’re providing skilled ot services, it Yeah, and be billed the same way that that any other skilled ot service in any other setting would be billed? Laura Petix 46:19 Do you still do like a traditional evaluation like with the bot or the like the p body or things like at an indoor setting? And then build off of that? Or do you have just the opposite, like, sensory observation that you do like out in nature, if you’re like in taking a child? Speaker 1 46:38 It kind of depends on the on the practice, right? Like, I guess to say what my practice does. For our groups, we do kind of what I call a OT, assessment light, you know, we bill it as a minimum complexity of vowel or low complexity. Val. Okay. Right, whatever a OTA would, would call it. Yeah, that’s our Yeah. Professional Association. Yeah, but for our for our individual kids. We do like a standard assessment like that, with standardized testing, we don’t have an indoor setting, we don’t we don’t have an indoor place to do it. The bot would be like a very rare occurrence that we would use the bot. Okay. Okay, we have a variety of other like standardized assessments that we would use. Yeah. And then we we do, we do a lot of observational stuff, too. Because there are, there are things that when we do an individual evaluation, in nature, you kind of you kind of can observe a lot of like motor skills and sensory processing things through observation. And actually, that’s one thing that really surprised me in my assessment course that I took in my PhD coursework was that non standardized assessments are actually just as valid, essentially, as standardized assessments. And it encouraged my, my professional heart to know that because I do feel like a lot of times standardized assessments are very narrow in their focus and not kind of giving the whole picture. I mean, I don’t think anyone would say a standard is assessment gives a whole picture of a kid but it’s hard because it’s therapist I think we liked that black and white. We liked that the numbers there and it shows that I Laura Petix 48:26 think the insurance likes that I don’t think many therapists like it because I hated writing those reports on like, the percentile and I was like, Yeah, but it was because you know, so many other factors were impacting his ability to like grip grip, this one thing and you said, if I didn’t hold it like this, then it gets to zero. But I hated that. My like I am. So I’m a rule follower, but also like, but but but but but like, yeah, so hard to like, fully follow those things. Yeah. Speaker 1 48:56 Yeah. So So we definitely use more observational methods of assessment. Yeah. And we you know, we don’t work under the insurance model in my practice. So we have freedom to do that. Like we have freedom to talk with the parents and just say, Okay, what is the real thing? Yeah, we feel like is getting in the way of him participating in here and let’s write a goal specifically for that thing and you don’t have to worry about if the insurance company is going to say, well, that’s not a Maillot medically necessary goal. Right. So yeah, I do. You know, I don’t feel free to cut this out if you don’t want this out on your podcast. Like I do feel really strongly that when when parents are looking at therapy service providers, really think about like if you are if you are going to if you are going to use your insurance, or you have the opportunity to look at some private pay like things that are available in your area. Sometimes the private pay model can actually be more affordable. It sounds crazy. But if you are if you are paying for or a in a private pay way for services that are really going to be geared towards specific things that you want to work on. And that might be getting in the way of your kids participation. versus in a insurance based setting, you might get shorter sections with like, really high co pays per session a lot of times, so you might end up spending about the same or, you know, it’s just do the research, I Laura Petix 50:25 guess value, though, the value of what they’re getting is, it’s for sure that and I do find that and I tell this to parents freely all the time, as I understand accessibility and affordability, like is, like, that’s gonna be a huge barrier, whether or not you see the value in private costs, if you can’t afford it, I get it. And so obviously, take what you get. But if you have a choice, and you asked me, more of the trained therapists are in these private pay cash based clinics, they’re, they’re more sensory trained, they’re more versed in the, in the different methods because insurance tends to not want to cover those other right, those those those things, those modalities. So then those therapists don’t get trained at those at those insurance based clinics. It’s not like across the board, but a lot of the time. And then this is what I hear a lot from parents like, Well, I went to OT because I heard ot helps with this, but like my OT is only working on like, pencil grasp and like we’re there for like, meltdowns and like behavioral stuff. And yeah. And it’s it’s, it’s, it’s it’s the game that people have to play for insurance, which is obviously like a big system. issue. Yeah. Yeah. But okay, so where if people are hearing this episode, and they are like motivated, and they want to find a therapist near them that does this, like, is there a database? Like how would you what are like key terms they could search for, to try to find something like this near them. Speaker 1 51:57 So I would type into Google nature based occupational therapy near me, that’s what that’s what I would do. Because most most, if you’re looking for an OT, specifically, the term is nature based, you also could search outdoor occupational therapy, that might be another another one that would come up. But nature based is kind of the term that a lot of people use. So you’d probably find something if you type that into Google. If there is something near you, and ask around, like ask ask people in your community to because there are more and more of, of these practices, even clinic based practices, maybe having like a summer camp, that would be an outdoor program, right for their kids, so or for the kids they serve. So yeah, I think that would probably be the best bet. Because most, most therapists nowadays have a website and Google’s pretty good at knowing who’s near whom, right. So Laura Petix 52:55 you should have a database of the therapists who go through your training because you train that that like you have a program. kind of Speaker 1 53:01 short. Yeah, we just started the the certification process last year. So there’s not very many people there. But yes, if people want to go there, it’s contigo Co N Okay, IG O. And you can go there, but there aren’t there aren’t a lot of people on there because I started the certification. Four years after I started training people, so it’s kind of, you know, there’s like 130 It’s, but there’s like 20 people on the on the certification now. So, yeah, more will be coming. But yes, people could people could go there as well. That would be great. And Laura Petix 53:36 then do you want to shout out your nature based practices in case anybody listening lives? Yeah, sure. To add this. Yeah. Speaker 1 53:44 So my practice, we’re on Instagram at outdoor kids OT, so you can follow along there on our outdoor adventures. We’re also on Facebook, too. I post more on Instagram, but you know, they they kind of Yeah, double double post to each platform. And I personally am on Instagram at Laura Park fig. But I My account is a little more geared towards like therapists who want to do outdoor work so the parents would probably be more interested in the outdoor kids. Oh, T accounts. So yeah. Laura Petix 54:13 And so you’re in Wisconsin, right? Yes. Yeah. Do you still have the outdoor nature one in? Was it Oakland or the bay area Speaker 1 54:21 or in the Bay Area? Yeah. Yeah, that’s okay. I mean, my main practice is still in California. I go back about three times a year and I have just a great team there that okay, they like are doing awesome. So we have a lot of you know, after this long in business, you have a lot of systems in place and without a physical location. It’s it’s we’re all remote anyway working for me to manage remotely, so but it keeps me I’m glad because it keeps me tied to the Bay Area. We lived there 14 years, so it’s nice to have to go back and see my best friends and my team. A few times are so yeah, I Laura Petix 54:55 love it. Okay, well, I hope people listening here are motivated or inspired urge to try getting their family outdoors a little bit more. And even if you don’t feel ready to go fully, fully outdoor frolicking in the woods barefoot, like, I challenge you to go outside and maybe do like a little scavenger hunt or something. So thank you so much for sharing all of your knowledge with us today, Laura. It’s been such a pleasure having this conversation with you. Thank Unknown Speaker 55:20 you, Laura. I loved it. Laura Petix 55:24 If you enjoyed this podcast, please consider rating it and leaving a review which helps other parents find me as well. Want to learn more from me? I share tons more over on Instagram at the OT butterfly. See you next time. Transcribed by




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Laura Petix, MS OTR/L

I’m an enneagram 6, so my brain is constantly moving. My OT lenses never turn off and I can’t “un-see” the sensory and other developmental skills that go in to literally every activity. I love taking what I see and breaking it down into simple terms so parents can understand what goes into their child’s behavior and skills.

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